1. Berryessa CM. {{Educator of the Court: The Role of the Expert Witness in Cases Involving Autism Spectrum Disorder}}. {Psychol Crime Law}. 2017; 23(6): 575-600.
The role of the expert witness in legal contexts is to educate fact finders of the court who may have no background in the expert’s area. This role can be especially difficult for those who assist in cases involving individuals with Autism Spectrum Disorder (ASD). As expert assistance on ASD is crucial to ensuring just outcomes for individuals diagnosed with ASD, knowledge on how expert witnesses perceive and approach their roles, and what factors may influence these perceptions, is essential. This qualitative research utilizes semi-structured interviews with a sample of expert witnesses in cases involving ASD, analyzed using a grounded-theory constant comparative analytic approach. Data reveal that experts appear to view their roles in court as reconstructionists, educators, myth-dispellers, and most of all, communicators, actively using their testimony to fill these roles in cases. These results also allow for the development of a model that illustrates two areas that coalesce to affect how experts view their roles in court: (1) personal experiences of experts in cases in which they have been involved; and (2) influences outside experts’ personal experiences, such as their general opinions or observations regarding ASD and its relationship to the criminal justice system.
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2. Handen BL, Anagnostou E, Aman MG, Sanders KB, Chan J, Hollway JA, Brian J, Arnold LE, Capano L, Williams C, Hellings JA, Butter E, Mankad D, Tumuluru R, Kettel J, Newsom CR, Peleg N, Odrobina D, McAuliffe-Bellin S, Marler S, Wong T, Wagner A, Hadjiyannakis S, Macklin EA, Veenstra-VanderWeele J. {{A Randomized, Placebo-Controlled Trial of Metformin for the Treatment of Overweight Induced by Antipsychotic Medication in Young People With Autism Spectrum Disorder: Open-Label Extension}}. {J Am Acad Child Adolesc Psychiatry}. 2017; 56(10): 849-56 e6.
OBJECTIVE: A previous study reported on a 16-week placebo-controlled, randomized clinical trial (RCT) of metformin for weight stabilization in 61 children and adolescents 6 to 17 years old with autism spectrum disorder who were prescribed atypical antipsychotics. The present study describes the results of a 16-week open-label extension. METHOD: Fifty-two participants from the acute trial (85%) entered the extension; 22 had been on metformin during the initial RCT and 30 had been on placebo. Participants were re-titrated to 500 mg twice a day (6- to 9-year-olds) or 850 mg twice a day (10- to 17-year-olds) during the open-label extension. Primary outcome measure was change in body mass index (BMI) z-score after 16 weeks; secondary outcomes were change in additional body composition and metabolic parameters. RESULTS: After 16 weeks of open-label treatment, participants initially taking placebo during the RCT had lower BMI z-scores (mean 16-week change -0.10, p = .004). Statistically significant improvements also were noted in secondary body composition measures (weight z-score and BMI and weight percentile) but not in metabolic variables. Participants who initially had been taking metformin during the 16-week RCT maintained prior decreases in BMI z-scores but did not have additional weight loss. Three participants discontinued treatment because of an adverse event. No significant changes were noted on metabolic measures, although the decrease in hemoglobin A1c was large ( approximately 1 mmol) and consistent across the acute and open-label phases. CONCLUSION: Metformin can be effective for decreasing weight gain associated with atypical antipsychotic use and maintaining prior improvement in children and adolescents with autism spectrum disorder. Clinical trial registration information-Treatment of Overweight Induced by Antipsychotic Medication in Young People With Autism Spectrum Disorders (ASD); http://clinicaltrials.gov/; NCT01825798.
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3. Honda T, Sofuku K, Matsunaga H, Tachibana M, Mohri I, Taniike M, Tomonaga K. {{Detection of Antibodies against Borna Disease Virus Proteins in an Autistic Child and Her Mother}}. {Jpn J Infect Dis}. 2017; 70(5): 599.
Volume 70, no 2, p.225-227, 2017. Page 226, Figure 1B and C should appear as shown below.
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4. Jones CRG, Simonoff E, Baird G, Pickles A, Marsden AJS, Tregay J, Happe F, Charman T. {{The association between theory of mind, executive function, and the symptoms of autism spectrum disorder}}. {Autism Res}. 2017.
It has been strongly argued that atypical cognitive processes in autism spectrum disorder (ASD) contribute to the expression of behavioural symptoms. Comprehensive investigation of these claims has been limited by small and unrepresentative sample sizes and the absence of wide-ranging task batteries. The current study investigated the cognitive abilities of 100 adolescents with ASD (mean age = 15 years 6 months), using 10 tasks to measure the domains of theory of mind (ToM) and executive function (EF). We used structural equation modelling as a statistically robust way of exploring the associations between cognition and parent-reported measures of social communication and restricted and repetitive behaviours (RRBs). We found that ToM ability was associated with both social communication symptoms and RRBs. EF was a correlate of ToM but had no direct association with parent-reported symptom expression. Our data suggest that in adolescence ToM ability, but not EF, is directly related to autistic symptom expression. Autism Res 2017. (c) 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The behaviours that are common to autism spectrum disorder (ASD) have been linked to differences in thinking ability. We assessed autistic adolescents and found that social communication difficulties and the presence of restricted and repetitive behaviours related to difficulties in understanding other peoples’ minds (theory of mind). In contrast, these behaviours were not associated with the general thinking abilities involved in planning and executing tasks (executive function).
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5. Joshi G, Arnold Anteraper S, Patil K, Semwal M, Goldin R, Furtak S, Chai XJ, Saygin Z, Gabrieli JD, Biederman J, Whitfield-Gabrieli S. {{Integration and Segregation of Default Mode Network Resting-state Functional Connectivity in Transition-age Males with High-functioning Autism Spectrum Disorder: A Proof of Concept Study}}. {Brain Connect}. 2017.
OBJECTIVES: To assess the resting-state functional connectivity (RsFc) profile of the default mode network (DMN) in transition-age males with autism spectrum disorder (ASD). METHODS: Resting-state blood oxygen level dependent functional MRI (fMRI) data were acquired from adolescent and young adult males with high-functioning ASD (N=15) and from age-, sex-, and IQ-matched healthy controls (HC; N=16). The DMN was examined by assessing the positive and negative RsFc correlations of an average of the literature-based conceptualized major DMN nodes (medial prefrontal cortex [mPFC], posterior cingulate cortex, bilateral angular and inferior temporal gyrii regions). RsFc data analysis was performed using a seed driven approach. RESULTS: ASD was characterized by an altered pattern of RsFc in the DMN. The ASD group exhibited a weaker pattern of intra- and extra- DMN positive and negative RsFc correlations respectively. In ASD the strength of intra-DMN coupling was significantly reduced with the mPFC and the bilateral angular gyrii regions. In addition, the polarity of the extra-DMN correlation with the right hemispheric task-positive regions of fusiform gyrus and supramarginal gyrus was reversed from typically negative to positive in the ASD group. A wide variability was observed in the presentation of the RsFc profile of the DMN in both HC and ASD groups that revealed a distinct pattern of sub-grouping using pattern recognition analyses. CONCLUSIONS: These findings imply that the functional architecture profile of the DMN is altered in ASD with weaker than expected integration and segregation of the DMN RsFc. Future studies with larger sample sizes are warranted. Key Words: autism spectrum disorder, resting-state fMRI, default mode network.
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6. Keown CL, Datko MC, Chen CP, Maximo JO, Jahedi A, Muller RA. {{Network organization is globally atypical in autism: A graph theory study of intrinsic functional connectivity}}. {Biol Psychiatry Cogn Neurosci Neuroimaging}. 2017; 2(1): 66-75.
BACKGROUND: Despite abundant evidence of brain network anomalies in autism spectrum disorder (ASD), findings have varied from broad functional underconnectivity to broad overconnectivity. Rather than pursuing overly simplifying general hypotheses (‘under’ vs. ‘over’), we tested the hypothesis of atypical network distribution in ASD (i.e., participation of unusual loci in distributed functional networks). METHODS: We used a selective high-quality data subset from the ABIDE datashare (including 111 ASD and 174 typically developing [TD] participants) and several graph theory metrics. Resting state functional MRI data were preprocessed and analyzed for detection of low-frequency intrinsic signal correlations. Groups were tightly matched for available demographics and head motion. RESULTS: As hypothesized, the Rand Index (reflecting how similar network organization was to a normative set of networks) was significantly lower in ASD than TD participants. This was accounted for by globally reduced cohesion and density, but increased dispersion of networks. While differences in hub architecture did not survive correction, rich club connectivity (among the hubs) was increased in the ASD group. CONCLUSIONS: Our findings support the model of reduced network integration (connectivity with networks) and differentiation (or segregation; based on connectivity outside network boundaries) in ASD. While the findings applied at the global level, they were not equally robust across all networks and in one case (greater cohesion within ventral attention network in ASD) even reversed.
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7. Syed MA, Yang Z, Hu XP, Deshpande G. {{Investigating Brain Connectomic Alterations in Autism Using the Reproducibility of Independent Components Derived from Resting State Functional MRI Data}}. {Front Neurosci}. 2017; 11: 459.
Significance: Autism is a developmental disorder that is currently diagnosed using behavioral tests which can be subjective. Consequently, objective non-invasive imaging biomarkers of Autism are being actively researched. The common theme emerging from previous functional magnetic resonance imaging (fMRI) studies is that Autism is characterized by alterations of fMRI-derived functional connections in certain brain networks which may provide a biomarker for objective diagnosis. However, identification of individuals with Autism solely based on these measures has not been reliable, especially when larger sample sizes are taken into consideration. Objective: We surmise that metrics derived from Autism subjects may not be highly reproducible within this group leading to poor generalizability. We hypothesize that functional brain networks that are most reproducible within Autism and healthy Control groups separately, but not when the two groups are merged, may possess the ability to distinguish effectively between the groups. Methods: In this study, we propose a « discover-confirm » scheme based upon the assessment of reproducibility of independent components obtained from resting state fMRI (discover) followed by a clustering analysis of these components to evaluate their ability to discriminate between groups in an unsupervised way (confirm). Results: We obtained cluster purity ranging from 0.695 to 0.971 in a data set of 799 subjects acquired from multiple sites, depending on how reproducible the corresponding components were in each group. Conclusion: The proposed method was able to characterize reproducibility of brain networks in Autism and could potentially be deployed in other mental disorders as well.
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8. Tilahun D, Fekadu A, Tekola B, Araya M, Roth I, Davey B, Hanlon C, Hoekstra RA. {{Ethiopian community health workers’ beliefs and attitudes towards children with autism: Impact of a brief training intervention}}. {Autism}. 2017: 1362361317730298.
There is a severe shortage of services for children with autism in Ethiopia; access to services is further impeded by negative beliefs and stigmatising attitudes towards affected children and their families. To increase access to services, care provision is decentralised through task-shifted care by community health extension workers. This study aimed to examine the impact of a brief training (Health Education and Training; HEAT) for Ethiopian rural health extension workers and comprised three groups: (1) health extension workers who completed a basic mental health training module (HEAT group, N = 104); (2) health extension workers who received enhanced training, comprising basic HEAT as well as video-based training on developmental disorders and a mental health pocket guide (HEAT+ group, N = 97); and (3) health extension workers untrained in mental health (N = 108). All participants completed a questionnaire assessing beliefs and social distance towards children with autism. Both the HEAT and HEAT+ group showed fewer negative beliefs and decreased social distance towards children with autism compared to the untrained health extension worker group, with the HEAT+ group outperforming the HEAT group. However, HEAT+ trained health extension workers were less likely to have positive expectations about children with autism than untrained health extension workers. These findings have relevance for task-sharing and scale up of autism services in low-resource settings worldwide.
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9. Wu YT, Maenner MJ, Wiggins LD, Rice CE, Bradley CC, Lopez ML, Kirby RS, Lee LC. {{Retention of autism spectrum disorder diagnosis: The role of co-occurring conditions in males and females}}. {Res Autism Spectr Disord}. 2016; 25: 76-86.
This study examined associations between ASD diagnosis retention and non-ASD co-occurring conditions (CoCs) by child sex. The sample included 7077 males and 1487 females who had an ASD diagnosis documented in their school or health records in a population-based ASD surveillance system for 8-year-old children. ASD diagnosis retention status was determined when an initial ASD diagnosis was not later ruled out by a community professional. We found that ASD diagnosis remains fairly stable, with only 9% of children who had an initial documented ASD diagnosis later being ruled-out. Although most of the associations between the ASD diagnosis retention status and CoCs are similar in both sexes, the co-occurrence of developmental diagnoses (e.g., intellectual disability or sensory integration disorder) was predictive of ASD diagnostic changes in males, whereas the co-occurrence of specific developmental (e.g., personal/social delay) and neurological diagnosis (e.g., epilepsy) was associated with ASD diagnostic change in females. More ASD-related evaluations and less ASD-related impairment were associated with later ASD rule outs in both sexes. Our findings highlight that CoCs can complicate the diagnostic picture and lead to an increased likelihood of ambiguity in ASD diagnosis. Using sensitive and appropriate measures in clinical practice is necessary for differential diagnosis, particularly when there are co-occurring developmental conditions.
